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ANN RHEUM DIS:退行性半月板撕裂关节镜半月板切除术疗效观察

2017-05-28 xiangting MedSci原创

在对没有骨性关节炎但有退行性内侧半月板撕裂症状的患者进行2年随访期间,APM的疗效不优于安慰剂手术。

这项研究为了评估关节镜部分半月板切除(APM)在治疗退行性内侧半月板撕裂时是否优于安慰手术。

在这项多中心随机、双盲、安慰剂对照的试验中,146例35-65岁的成年人,有退行性内侧半月板撕裂,无膝关节骨关节炎,随机分为APM或安慰剂手术。主要结果是手术后24个月的运动后膝关节疼痛和Meniscal评估工具(WOMET)与Lysholm膝关节评分之间的差异。次要结局包括治疗组分配,参与者满意度,变化印象,恢复正常活动,严重不良事件发生率和临床检查中半月板症状存在的频率。同时进行两个亚组分析,评估有机械性症状和不稳定半月板撕裂的结局。

在意向性治疗分析中,组间WOMET评分从基线至24个月的变化差异无显著性:APM组为27.3,对照组为31.6(组间差异 -4.3; 95%CI,-11.3-2.6); Lysholm膝关节评分:分别为23.1和26.3(-3.2; -8.9至2.4)或运动后膝盖疼痛分别为3.5和3.9(-0.4; -1.3至0.5)。在任何次要结局或分析的亚组中,两组之间无显著差异。

在对没有骨性关节炎但有退行性内侧半月板撕裂症状的患者进行2年随访期间,APM的疗效不优于安慰剂手术。没有证据支持存在机械症状或某些半月板撕裂特征,或初始保守治疗失败的患者更有可能从APM中获益的说法。

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    2017-05-30 xzw114

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